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DUVALL ENTERPRISES, INC
CAH041302-00 DARDANELLE HOSPITAL
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Covered Entity Details
Entity Name
DARDANELLE HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041302-00
Entity Address
200 NORTH THIRD
DARDANELLE, AR 72834
Medicare Provider Number
041302
Participating Start Date
4/28/2021
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
DUVALL ENTERPRISES, INC
Pharmacy Address
DBA ROSE DRUG OF DARDANELLE
1176 STATE HIGHWAY 22 W STE A
DBA ROSE DRUG OF DARDANELLE
DARDANELLE, AR 72834-3006
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Reed, VP of Clinical Support Services/CIO
(501) 513-5152
Contract Pharmacy Representative
Duvall Enterprises
Marsha Duvall, President
(479) 229-4040
Signed By Date
7/15/2021
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